Journaling – writing down your thoughts and feelings to understand them more clearly – improved the mental health of adolescents with cystic fibrosisreveal the results of a feasibility study.
All teens with cystic fibrosis (CF) who responded to post-treatment surveys said journaling helped them express their feelings and recommended other people with CF write about the topics included in the study.
“We hope that this study design can be expanded to more participants in a formal study,” the researchers wrote in the study.The Positive Impact of Journaling on Adolescents With Cystic Fibrosis», published in the journal Pediatric pulmonology.
Beyond the numerous physical exams symptoms Experienced by people with cystic fibrosis, many face psychological stresses, such as anxiety, depression, feelings of isolation and difficulty managing relationships. These additional factors are associated with poorer treatment adherence, poorer lung function, and other health problems.
One promising approach to addressing these challenges is narrative therapy, which involves journaling. Research has demonstrated that journaling to explore psychologically distressing topics can improve self-awareness and understanding, laying the foundation for positive cognitive change.
Yet, little research has focused on children and/or adolescents, particularly those with chronic diseases like cystic fibrosis.
That’s why researchers at Children’s Hospital Los Angeles, California, tested the feasibility of narrative therapy for adolescents with CF in an effort to improve their mental and physical health.
Adolescents with cystic fibrosis were aged 12 to 17
A group of eight adolescents, aged 12 to 17, was recruited through the hospital. Participants received an email each week for eight weeks encouraging them to keep a journal exploring topics such as living with CF, treatment adherence, feeling different from CF, limitations, anxiety , depression and relationships.
They also completed surveys, before and after narrative therapy, about their experiences. Well-being was also assessed using the Pediatric Symptom Checklist (PSC-17), a questionnaire aimed at identifying changes in emotional and behavioral problems in youth. Higher scores, especially those above 28, are a sign of significant behavioral or emotional problems.
During the study period, PSC-17 scores dropped from an average of 29 to 23.5, representing a decrease of 5.5 points, signifying a decrease in behavioral or emotional problems. These results were observed despite slight reductions in average lung function and weight loss during the study.
Improvements in most mental health questions were seen in post-intervention surveys compared to before therapy. There were fewer days when participants self-reported that their physical and mental health was poor and interfered with their daily activities. A decrease in the number of days of pain, sadness, anxiety and lack of sleep were also reported.
Before therapy, two of the four participants who completed the entire study answered “Yes” to the question “Are you limited in any way in your activities due to any impairment or problem health ? » At the same time, one of them answered “Don’t know/Not sure” and the other answered “No”. After therapy, two of the participants responded “No” and two responded “I don’t know/I’m not sure.”
When asked about other topics participants wanted to write about, they responded “What our relationships or friendships are like with CF” and “More positive things about my CF on how you can have a healthy view of CF or how there may be certain things that CF patients have an advantage.
Post-therapeutic investigations
When asked what they liked about the study, participants said “the week we have to hand it in” and the topics offered varied. When asked about problems/changes related to the study, participants felt obligated to answer the questions within a week, and two of them specifically mentioned wanting to write about more positive topics.
All those who completed post-treatment surveys said the study helped them express their feelings and all recommended other people with cystic fibrosis write about the study topics. Three in four said they enjoyed participating in the research and that their writing could help providers know them better. Three also responded that the study helped them combat anxiety and depression related to cystic fibrosis. Only one said the study helped them manage CF better.
Participant comments included: “I enjoyed participating in this study because I felt like I had a safe space to talk about my issues and obstacles I faced with my CF (as well as of my accomplishments and all the positive things that have happened with my CF). »
Thinking about cystic fibrosis “in a different light”
Additionally, “I enjoyed participating in the journal study because it helped me look at my CF from a different perspective. Usually, I avoid thinking and talking about my CF or thinking about the things that make me different from others. This study helped me realize that I’m not the only person with CF who can have these experiences” and “I enjoyed it because it helped me explore and understand.”
“This pilot feasibility study to implement a journaling intervention for people with cystic fibrosis was successful,” the researchers concluded. “Our expected level of participation and study completion was exceeded. »
A limitation of the study the team mentioned was that patients had relatively preserved lung function at the start of the study and a low average hospitalization in one year, meaning the included participants “may not be the most representative of all people with cystic fibrosis.
